Erectile dysfunction is inability of a man to achieve and maintain erection necessary for satisfactory sexual function. This term came to replace «impotence» term, was proposed in 1988 by US National Institute of Health and since 1992 has been adopted by international organizations of urologists and andrologists.
Problem of impotence has not only medical, but also extremely important social significance. Disharmony of sexual relations is often the cause of family breakdown, infertility, depression and even suicide.
At present, there is tendency of increasing frequency of erectile dysfunction cases; it is estimated that this disease affects over 100 million men in the world. Because of false modesty or lack of qualified specialists or for other reasons most men either do not go to doctor, or do it untimely. This in its turn leads to disappointing results of therapy and establishment of the opinion among men that treatment of this disease is of low effectiveness.
However, at present time, doctors have reliable medicinal substances for effective treatment of erectile dysfunction. In addition, there appeared fundamentally new methods of conservative therapy aimed at stimulating angiogenesis of cavernous tissue of penis, that is, development of additional blood circulation in structures of penis, which leads to qualitative improvement in erection.
There were modernized methods of surgical treatment of erectile dysfunction. Currently, microsurgical technique is used for operations on penile vessels with vascular-conditioned erectile dysfunction, further development of prosthetic surgery of penis is developed.
All this makes it possible to assert that with timely treatment of problems in intimate sphere, in overwhelming majority of cases one can expect high efficiency from treatment of this socially significant disease and real help will be received not only by men, but also by their sexual partners. At the same time, timely treatment will make it much less invasive (gentle, not including complex operations) and more effective treatment.
How Often does Erectile Dysfunction Occur?
Percentage of men who experienced some form of erectile dysfunction (by age):
- til 20 years – 5%;
- 20 – 30 years – from 10 to 30%;
- 30 – 40 years – from 30 to 40%;
- 40 – 50 years – from 40 to 50%;
- 50 – 60 years – from 50 to 60%;
- 60 years and older – from 60 to 80%.
Types of Erectile Dysfunction
- complete absence of erection;
- unstable erection;
- episodic erectile dysfunction.
To achieve normal erection, you need:
- healthy nervous system that reacts flexibly to impulses of brain;
- healthy blood vessels of penis;
- healthy muscular and connective tissues of penis;
- required level of nitric oxide in soft tissues of genital organs.
Causes of Erectile Dysfunction
- vascular problems (hypertension and impaired blood flow to genitals);
- diabetes – provokes disorders of nervous system – diabetic neuropathy;
- low level of testosterone;
- harmful habits (alcohol, smoking, drugs, abuse of strength sports and taking anabolic drugs);
- stressful situations – chronic stress and special stressful situations.
Erectile Dysfunction Symptoms
The main signs are:
- difficulties with achieving or maintaining erection;
- erection becomes weaker;
- support for erection is achieved only by conscious effort;
- morning erection becomes less frequent and firm.
One of the factors impeding effective treatment is unwillingness of men to consult a doctor. Violation of erection is usually considered a personal problem, which nobody is told about. Also, some men think that erectile dysfunction is incurable, but this is not true: in 95% of cases erectile dysfunction can be cured.
As mentioned earlier, impotence is not a disease itself but merely a symptom of another disease, therefore, depending on diagnosis, therapeutic, medication or psychological treatment is chosen.
Treatment of Erectile Dysfunction
Treatment of impotence is always targeted: it takes into account age of patient, his physical and psychoemotional state, constitution, tolerability of certain types of medications.
All treatment methods can be divided into 2 large groups: conservative therapy and surgical treatment.
The first group is conservative therapy, that is, treatment without surgery. This group of methods includes:
- appointment of selective inhibitors of phosphodiesterase type 5;
- substitution therapy with androgens;
- vacuum-constrictor devices (apparatus for LNP-therapy);
- intracavernous administration of drugs into cavernous body;
- combined therapy (combination of these methods).
A new, effective and promising method for erectile dysfunction treatment is method of stimulating angiogenesis of penis with the help of shock wave technology. Effect of acoustic shock waves of low intensity on cavernous tissue does not lead to side effects, it allows to carry out treatment without pharmacological drugs for erectile dysfunction (Viagra, Cialis, Levitra, etc.), is highly effective.
* Psychological treatment. Treatment of psychological forms of impotence is carried out by psychotherapist who specializes in treatment of psychosexual disorders.
Surgical treatment of sexual function:
- operative treatment of venous insufficiency of penis is performed in case of defeat of vaso-occlusal mechanism. Candidates for operation on veins of penis are men of younger age and preferably without concomitant diseases (diabetes, cardiovascular problems, anamnesis of smoker, etc.);
- penile prosthesis. Setting special prosthesis in place of cavernous bodies of penis is the most radical way to restore erectile function. Currently, there are several types of prostheses, and the simplest of them is semi-rigid rods, but today more complex devices are used, based on elastic cylinders, in which liquid is injected and erection appears. Disadvantages of endoprosthetics include possibility of complications and complete irreversibility of surgery.